Provider Demographics
NPI:1952681066
Name:QUANTUM DENTAL
Entity Type:Organization
Organization Name:QUANTUM DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-904-0987
Mailing Address - Street 1:14250 BELLAIRE BLVD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-7523
Mailing Address - Country:US
Mailing Address - Phone:281-904-0987
Mailing Address - Fax:
Practice Address - Street 1:14250 BELLAIRE BLVD
Practice Address - Street 2:SUITE #4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-7523
Practice Address - Country:US
Practice Address - Phone:281-904-0987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX270631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty